Apr 21, 2010
Healthcare worker flu shots: mandates and vaccination rates
Mandated flu vaccinations for healthcare workers (HCWs) are legally defensible, although union contracts and state public health laws and regulations may limit employers' ability to strictly enforce such mandates. This conclusion of a recent study is being presented today at the National Immunization Conference in Atlanta. Employers' failure to provide for certain fundamental employee rights could also invalidate mandates. Also being presented in the same conference session is a study from Iowa giving results of a 3-year intervention to see that 95% of the state's HCWs were receiving flu vaccinations annually by 2010. All hospitals received educational packets and were able to report rates online. Reporting rates started at 86% but went to 100% by the second season. HCW vaccination rates in season 1 ranged from 44% to 99%, in season 2 from 47% to 100%, and in season 3 from 53% to 100%, all above the national average of 10% to 40%. The rates were highest in rural and small hospitals and in those that used declination statements in their efforts.
Better primary care cited as possible aid to dengue control
A study that looked at neighboring cities in Brazil indicates that a markedly lower incidence of dengue cases in one of the cities may be attributable to better primary care. The study, published in the current Bulletin of the World Health Organization, noted that climate, population, and sanitation rates are similar between Rio de Janeiro and nearby Niteroi. But Rio's dengue incidence is twice as high. One notable difference between the cities that may account for the lower dengue incidence in Niteroi is that this city has seen an increase in primary healthcare coverage from less than 1% to 77% in the last 20 years, compared with 7% coverage in Rio. Niteroi's local family health strategy includes local health agents who live in the community, educate people on the disease, and look for potential breeding grounds of dengue-carrying mosquitoes around homes. The report says, "These local agents are essential in combating potential foci of Aedes aegypti, having visited 82% of all Niteroi homes in 2007." The study also says differences in disease reporting are unlikely to play a role in the dengue discrepancy. Brazil accounts for 4.5 million dengue cases each year, about 78% of all reported cases in the Americas.
April Bull World Health Organ report